Insomnia

The amount of sleep needed each night varies from person to person, but most healthy men need 8 to 81⁄2 hours of sleep per night to be fully alert during the day. If a man does not get enough sleep—even for one night—he may experience drowsiness that disrupts his daily routine.

Certain medical conditions and drugs also can interrupt sleep and cause daytime drowsiness. Problems such as asthma, congestive heart failure, and rheumatoid arthritis or any other painful condition can keep you from getting a good night’s sleep. Medication used to treat high blood pressure or heart disease, and asthma medications such as theophylline, also can interfere with sleep. Alcohol can help you to fall asleep but causes sleep disruption later in the night and can produce early morning headaches. The sedative effects of alcohol also can put you at increased risk for motor vehicle collisions if you drink and drive. Caffeine, which stays in the body for 3 to 7 hours after ingestion, makes it harder to fall asleep and stay asleep. The nicotine in cigarettes and nicotine patches is a stimulant that also can disrupt sleep.

Many men who work the night shift have difficulty sleeping. Most night-shift workers get less sleep overall than day workers. The human sleep-wake cycle is designed to prepare the body for sleep at night and wakefulness during the day. These natural rhythms make it harder for a person to sleep during the day and to work at night. In addition, lights, noise (such as from telephones), and family members can be annoying distractions that disrupt daytime sleep.

If you have problem with sleepiness, monitor your sleep-wake patterns. If you are consistently getting fewer than 8 hours of sleep per night, try to get more sleep by gradually moving to an earlier bedtime. If your schedule does not permit you to go to bed earlier, try to squeeze in a 30- to 60-minute daily nap. If you are sleepy, do not drive; sleepiness will increase your risk of having a collision.

If you think you are getting enough sleep but still feel sleepy during the day, you may have a sleep disorder. Talk to your doctor, who can evaluate your symptoms and prescribe appropriate treatment.

Some men have medically recognized sleep disorders. The most common sleep disorders are insomnia, sleep apnea, narcolepsy, and restless legs syndrome.

Insomnia
Most people need a full 8 hours of sleep, while some can function well with less. Many people, however, are unsatisfied with the amount of sleep they get. Insomnia refers to inadequate or poor-quality sleep, usually the result of difficulty falling asleep, frequent waking during the night, or rising too early in the morning. Once the person wakes during the night or early in the morning, he or she has difficulty going back to sleep. Insomnia can cause fatigue, lack of energy, difficulty concentrating, and irritability.

Insomnia that lasts only a few weeks or less is called transient insomnia. If episodes of insomnia occur from time to time, the problem is called intermittent insomnia. Insomnia that occurs on most nights and lasts a month or longer is called chronic insomnia.

Factors that may contribute to insomnia include being older and having a history of depression. Although insomnia occurs in men and women of all ages, it seems to be more common in women and older people. Transient insomnia and intermittent insomnia often occur in people who are experiencing temporary problems such as stress, noisy sleeping conditions, extreme heat or cold, jet lag, or side effects of medications.

The causes of chronic insomnia are more complex, often involving a number of underlying disorders. One of the most common causes of chronic insomnia is depression. Other causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson’s disease, and hyperthyroidism.

Lifestyle factors such as overuse of caffeine, alcohol, or other drugs; shift work; smoking cigarettes before bedtime; excessive daytime napping; or chronic stress also have a role in the development of insomnia. Stopping these behaviors may help eliminate insomnia.

If you have insomnia, your doctor will take a complete health history and a sleep history. To obtain a sleep history, the doctor will ask you to keep a sleep diary or interview your sleep partner to find out how much sound sleep you typically get each night. Transient and intermittent insomnia may require no treatment because it often clears up when the underlying problem, such as jet lag, is resolved. If your daytime performance is adversely affected by transient insomnia, your doctor may prescribe a short-acting sleeping pill for a brief period.

To treat chronic insomnia, your doctor will first diagnose and treat any underlying medical or psychological problems you may have. He or she may prescribe a sleeping pill, but only for a brief period to minimize unwanted side effects or dependence on the pills for sleep. Certain behavioral techniques also are often used to improve sleep. One such technique is relaxation therapy, which is used to eliminate anxiety and muscle tension. Some people with insomnia benefit from sleep restriction, which at first allows only a few hours of sleep each night, and gradually increases sleep time to a more normal span of time. Another helpful treatment is called reconditioning, which teaches the affected person to associate the bed and bedtime with sleep by avoiding use of the bed for any activity other than sleep or sex.
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